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Pus�ic wo�Ks <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 98201 <br />(425) 257�6810 <br />OYJNERNAME �^.c€ �iE.:�C'!S APPI <br />ANDADDRESS: PO SO:C l��,j$! - AND <br />EVERETT ;7A 98�f,h <br />9253595F,76 <br />PI{ONE: <br />TAX PARCEL I.D. k <br />Install <br />DFSCRIPTIOL' OF <br />PROi'OS[D VJORK: <br />�ERMIT CONDITIONS <br />PI10NE: <br />� <br />Dale <br />Public Works Permi� # <br />BuilCing Permit # <br />Planning Reference # <br />Public 4'Jorks Fee S <br />Guarantee 5 <br />a�on <br />il%'_7,'1G05 � <br />Pf�U51i-0?8 <br />S 4U . i�il <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-88t0 <br />2. All work shall be performed in accordance with ihis permit and curren� City of Everett Design and Construc�ion <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555 <br />9. A� per appeoved plsn dated 11/17/05 and the public �.�_�r;:a in�F:ectur's direct_on in <br />`he field. <br />P. rieep city strevts olean at all times during constLuctian - no tcacY,in� of dict oz <br />del.iis onrn rity street� is alloved. <br />>� <br />:: <br />- � � t�_,� � <br />`. ! <br />c� <br />:� <br />' ' e`�ri <br />�;r/��,lo <br />F� l.I V L � <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W` <br />r <br />V/ <br />W <br />O <br />� <br />Z <br />� <br />rH^ <br />V / <br />O <br />a <br />The undersigned ownerlapplicaM hereby agrees to hold and <br />save harmle=_s ihe Ci�y ot Everetl from any and all claims br <br />damages, cosis, expenses, or causes of action iha� may arise <br />/� rn� because of ins�allalion and maintenance ol �he improvement or <br />�° oiher righhof-way usa ,•ere�o applied for and lurther agrees to <br />remove same upon notice irom Ihe City and to replace public <br />pmperry d a ed th reby. <br />; � ��� ��Z3 S" <br />Si�nal e o pplicant Gate <br />wORK AUTHORIZED BV 7HIS PERRIIT MUST BE STARTED WITHIN teo DAVS OF DATE PERMIT IS ISSUEU AND THEREAFTER IS 70 0E DILIGEN7LV PURSUED <br />!�� COP.1PLFTION. THIS P[RIAIi M11AV pE CnNCF.LLED �V THE CITY UpON ANV STOPPAGE OF WORK ON 7H15 PROJEC7 OVER 90 �AVS �URA710N. <br />